Lin Houwei, Geng Hongquan, Xu Guofeng, Fang Xiaoliang, He Lei, Xu Maosheng
Department of Pediatric Urology, Xinhua Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China.
Children's Urolithiasis Treatment Center of Chinese Health Committee, Shanghai, China.
Front Pediatr. 2020 Apr 22;8:200. doi: 10.3389/fped.2020.00200. eCollection 2020.
To evaluate our use of external ureteral catheters in children with acute kidney injury (AKI) resulting from ceftriaxone-induced urolithiasis. From July 2010 to June 2015, a series of 15 children, including 12 males and 3 females, were referred to our department. All of them were diagnosed of post-renal AKI and underwent emergent hospitalization. Evaluation of serum electrolytes, creatinine (Cr), blood urea nitrogen (BUN), complete blood count, and blood gas analysis were completed in each child both before they were admitted, and again after surgery. Bilateral externalized ureteral catheters were placed cystoscopically in each of these patients. The composition of collected calculi was analyzed by infrared spectrography. Bilateral externalized ureteral catheters were placed successfully in all patients. There were no procedure-related complications. Two days after catheter placement, the levels of serum Cr and BUN had improved in all patients, and these levels were noted to be significantly lower than before catheterization ( < 0.001). Infrared spectrography demonstrated that the primary composition of all calculi collected was ceftriaxone. No recurrent AKI or renal deterioration was detected during the follow-up which ranged from 3 to 8 years. These results show that short-term external ureteral catheters can be effectively utilized in children with AKI caused by ceftriaxone-induced urolithiasis. We recommend this procedure as a viable replacement to indwelling stents in patients with bilateral ureteral stones.
评估我们在因头孢曲松诱导的尿路结石导致急性肾损伤（AKI）的儿童中使用外置输尿管导管的情况。2010年7月至2015年6月，一系列15名儿童（包括12名男性和3名女性）被转诊至我们科室。他们均被诊断为肾后性AKI并紧急住院。在每个儿童入院前和手术后再次完成血清电解质、肌酐（Cr）、血尿素氮（BUN）、全血细胞计数和血气分析评估。在这些患者中，通过膀胱镜检查为每位患者双侧放置外置输尿管导管。通过红外光谱分析收集结石的成分。所有患者双侧外置输尿管导管均成功放置。无手术相关并发症。导管放置两天后，所有患者的血清Cr和BUN水平均有所改善，且这些水平显著低于插管前（<0.001）。红外光谱显示收集的所有结石的主要成分是头孢曲松。在3至8年的随访期间未检测到复发性AKI或肾脏恶化。这些结果表明，短期外置输尿管导管可有效用于因头孢曲松诱导的尿路结石导致AKI的儿童。我们建议将此手术作为双侧输尿管结石患者留置支架的可行替代方案。
